It has been far too long since I wrote an update on my mother's health and condition. I'm afraid if I start, I'll find details I need to include, and it could take me all day, and I never HAVE all day available, so I just didn't say much of anything.
My mom's eating had decreased again, and she had a lot of weepy days, so in early June, the nursing home contacted me to tell me they were sending her to Norwood Hospital for psychiatric evaluation and treatment. (They had sent her to the ER at Morton Hospital a couple days earlier to try to find a physical cause for her not eating and sometime complaints of stomach pain; no physical cause was found.) It's a medical hospital that has two or three psych units, NOT just a psych hospital. This is good, because during her stay, she had increased difficulty with her breathing, and they found she had developed congestive heart failure (CHF). So, they sent her to a medical unit for several days to get the fluid out of her lungs, and when she was stable, they sent her BACK to the psych unit for a few more days, and then she was determined to be well enough to return to the nursing home, and to her great relief, she was finally sent back.
During her hospitalization, they made some medication changes, but there was little improvement. They decided to try electroconvulsive therapy (ECT, shock treatments), and I signed a consent for this on the day before I flew to DC for the SLA conference and TKN meeting. (I was rushing around like a madwoman trying to get everything done -- getting this fax taken care of, plus trying to get refills of my OWN medications, because the ones I'd ordered were coming by mail order and wouldn't arrive till the following Monday, and I was already completely out of two meds. That day was VERY STRESSFUL.) The social worker at Norwood assured me that there are several people involved in the decision to move forward with ECT. The patient's attending psychiatrist makes the first decision, but then it must be approved by the patient or the health care proxy (me), and another psychiatrist, and a medical doctor, and the anesthesiologist. I was afraid my mom would be mad at me for giving my consent, but really, if all these other doctors also agree that it's the best course of action, the patient's relative is most likely acting in the patient's best interest.
In my mom's case, the medical doctor also wanted a cardiologist's evaluation and approval. I thought they had gotten this, but "she'll have her first treatment tomorrow" became "she didn't start that yet," and then it was on hold, and then she developed CHF, and whatever medical approvals she'd received were basically void. During the last few days in the hospital, my mom's mood and appetite did improve a bit. Someone came from the nursing home to review her case, and gave the okay for her to return the following day.
I talked to the nursing home and hospice staff yesterday (before, during, and after my conference call -- yeah, THAT was fun! -- not really), and they said that with her respiratory issues and cardiac concerns, depression and anxiety, and the small amounts of food she's been eating, she IS eligible to receive hospice care again. She was actually the one who initiated the change, apparently asking if she could receive them. The social worker at the nursing home, Sue, said that she hates to see my mom so miserable, that the only time she's close to being content is when my grandmother visits (usually every two weeks), and since the hospice nurse evaluated her and they found she was eligible again, and the doctor agreed, then it could only help her to receive those extra services.
Jerilyn, the hospice social worker from last time, is on vacation this week, but she will be the one working with my mom again. I'm relieved to hear this, because Jerilyn knows Ma and likes her, and Ma likes Jerilyn as well, but more than that, Jerilyn knows the way Ma "operates," and she doesn't hesitate to use some "tough love," or to try to redirect her thoughts and attention, rather than just letting her go on about how bad she feels, and feeling sorry for her. (Wow, that might sound quite terrible.) But the fact that she likes Jerilyn, and enjoys those visits, makes her want to "be better," I think, and having extra visits and additional care led to positive results last year, and I hope it will happen again.
I knew this would not be a short post, I knew it, I knew it.
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